Provider Demographics
NPI:1669745253
Name:GARVIN, MARY MAUREEN (PA-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MAUREEN
Last Name:GARVIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MAUREEN
Other - Last Name:MCAULIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9134 SPRAGUE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-4053
Mailing Address - Country:US
Mailing Address - Phone:402-210-4090
Mailing Address - Fax:
Practice Address - Street 1:UNMC DIVISION OF ENDOCRINOLOGY
Practice Address - Street 2:983020 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3020
Practice Address - Country:US
Practice Address - Phone:402-559-6205
Practice Address - Fax:402-559-9504
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical